Experience With the Pipeline Embolization Device for Posterior Circulations Aneurysms: A Multicenter Cohort Study

Area of Science:

• Neurology
• Interventional Neuroradiology
• Vascular Surgery

Background:

• The Pipeline Embolization Device (PED) is used off-label for complex posterior circulation aneurysms.
• Existing data are limited to small, single-center retrospective studies.

Purpose of the Study:

• To assess the safety and efficacy of PED for posterior circulation aneurysms.
• To establish an international, multicenter collaboration for data collection.

Main Methods:

• Retrospective review of consecutive posterior circulation aneurysms treated with PED from 2012-2019.
• Data collected from 11 neurovascular centers included demographics, aneurysm/treatment characteristics, complications, occlusion, and outcomes.

Main Results:

• 149 aneurysms in 146 patients were treated; 16.4% presented with subarachnoid hemorrhage.
• High occlusion rates (>90%) achieved in 90.9% of aneurysms at 12-month follow-up.
• Neurologic complications occurred in 9.4%, with favorable outcomes (mRS 0-2) in 86.2% of patients.

Conclusions:

• PED is utilized for challenging fusiform and dissecting/blister posterior circulation aneurysms.
• Flow diversion with PED demonstrates acceptable neurologic complication rates (~10%) and good long-term occlusion.
• This multicenter data supports PED as a viable treatment option for these complex aneurysms.